Several options with Baker's cyst Robinul can help excess sweating Vaniqa cream used to retard facial hair Daily vodka dose can be detrimental

July 02, 2008

HEALTH MATTERS DR. PAUL DONOHUE Q. I have a Baker's cyst behind my left knee. It is painful when I bend the knee or when the leg has to bear weight, as in walking up stairs. I am 74. I exercise moderately every day, and I am not overweight. What would you suggest I do or refrain from doing in regard to the Baker's cyst? A. Want to keep it simple? You can do anything that doesn't cause the cyst to be painful. A Baker's cyst is a soft, behind-the-knee bulge. It's a swollen bursa. More than a hundred bursas are scattered throughout the body between tendons and bones. They prevent tendon irritation when the tendon rubs against the bone. A tunnel connects this behind-the-knee bursa with the knee joint. Swelling of the bursa indicates trouble in the knee -- arthritis, torn cartilage or some other problem. The knee, in response, produces more joint fluid, and that fluid flows into the bursa. That's how a Baker's cyst forms. Your doctor can drain the bursa with a needle and syringe and, at the same time, inject it with cortisone to prevent fluid from coming back. Only when the swollen bursa does not respond to these measures would surgery be necessary. How do you know this bulge is a Baker's cyst? If it's a self-diagnosis, have your doctor examine it. Other things can look very much like a Baker's cyst but are not. An aneurysm of an artery in the same region is an example. An aneurysm is an artery bulge caused by a weak spot in the artery wall. Q. I sweat excessively. Sweat drips off my face and runs down through my hair. I am 68 and have had this for at least 40 years. I cannot go outside in the summer without carrying something to wipe off the sweat. A. From 1 percent to 3 percent of the population suffers from hyperhidrosis -- excessive sweating. Such sweating can be localized to the palms, the soles, under the arms, to the head, face and neck or to the entire body. Antiperspirants containing aluminum chloride often can put an end to excessive sweating, but you have to be careful about using them on your face and scalp, as they might irritate you. You have to be extra careful not to get them in your eyes or on your eyelids. Glycopyrrolate, 1 mg or 2 mg, three times a day, can sometimes stop such sweating. Its trade name is Robinul or Robinul Forte. It is not FDA-approved for this use. Clonidine is another drug used to shut down sweating. In resistant cases where sweating leaves life in disarray, cutting or clamping nerves that supply the sweat glands can be done. This is a procedure performed by neurosurgeons. Q.I have heard about a cream for facial hair. I have had bad facial hair ever since menopause. The name of the cream is Vaniqa. Can you tell me anything about it? Waxing is expensive. A. Vaniqa cream has been around for quite some time, and many women have found it effective in retarding facial-hair growth. It shouldn't be used by pregnant or nursing women. Its side effects are few. It might make the skin burn or sting -- especially if the skin is broken -- and it can turn the skin red. There are many other ways to control facial hair -- shaving, bleaching, electrolysis, depilatories and laser treatments. Q. As with many people who are addictive by nature, I find myself at cocktail hour drinking 6-7 ounces of vodka daily. What lasting effects does excessive alcohol have on the body? I am concerned. A. Authorities in the use and abuse of alcohol say two drinks a day for men and one drink a day for women are the safe limits. A drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof whiskey. Your 6-7 ounces of vodka equal a little more than four drinks a day. Over the years, excessive amounts of alcohol can lead to heart damage (cardiomyopathy), nerve damage (neuropathy) and degeneration of the cerebellum, the part of the brain controlling movement and balance. Such volumes of alcohol can inflame the pancreas (pancreatitis), raise blood pressure, inflame the stomach and esophagus, and lead to liver cirrhosis. Granted that not everyone drinking these quantities of alcohol comes down with all or any of the above, but the danger is there. You'd be prudent to cut back. Readers may write to Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475.